What type of surgery is it?  How is it performed?  What about complications or pain? 

Dr. Perez performs a microsurgical procedure using surgical loupes - which is the recommended method for microsurgical procedures of this type.  The surgery is performed through a small incision (appx 4") just above your pubic area (bikini cut).  You will be mildly  sedated after entering the operating room and prior to surgery, so you will not feel the epidural or catheter being administered.   The tubes are repaired (method is determined by the type of ligation) by removing the damaged portion of the tube, and reconnecting the healthy ends.  In some cases, more extensive reconstruction may be required. 

Does he cut through the muscle and use stents? 

No.  The doctor does not cut through the abdominal muscle, which helps make healing quicker and less painful.  He does not use stents because they can cause damage to the inside of the tubes.  Please be sure to speak to the physician in advance about your surgery.

Does the doctor check to make sure the tubes are open? 

Yes.  The doctor uses saline to flush the tubes to make sure that the tubes are connected properly and that they are flowing freely

How many layers of sutures does he use to repair of the tubes?  What type of sutures does he use? 

Each layer of tube (3 layers) is stitched using a non-dissolvable micro-suture.

The sutures used to close the abdominal fatty layers just below the surface incision are dissolvable stitches, and the stitching method used to close your external incision is a cosmetic surgery technique which will minimize scarring and make the incision barely visible within a few months to a year.   

What type of anesthesia is used? What if I want something different? Why do I have to have an epidural?  

Unless you have certain allergies, severe obesity, or are medically unable - you will have an epidural because it is the safer method for this type of surgery.   You will not feel the epidural being administered.  Our anesthesiologist is excellent and highly skilled and the doctors will make the best decision based on your individual needs. If general anesthesia is required there will be additional costs.   We understand the fear of the epidural, and nearly every patient we see has those fears.  But we can safely say that almost every single patient we've served has left feeling completely different about the experience due to the way we administer the procedure. 

What if I want to be asleep for the surgery?  What if I want to be awake during surgery?

The anesthesiologist will use a mild sedative to help you relax or sleep (equivalent to the US drug, valium) while they prep you for surgery and do your epidural so you will not feel a thing.  If you want to be awake, let the doctor know and they will decrease the sedative dosage. If you want to sleep, they will increase the sedative to make sure you sleep through the whole procedure (there are additional fees for this). Above all, remember that you can have an open dialogue with the doctors here; they are receptive to allowing you to be involved in your care.

Is there a particular time that my reversal surgery needs to be done? If I start my period, do I have to cancel?

It is preferable to try to do surgery at a time 'other' than the time of your cycle but we also understand that the stress of travel and pending surgery can often cause even the most regular patient to start unexpectedly. It will not keep you from having your surgery or pose a problem (unless you are prone to very heavy bleeding).  Just be sure to let Dr. Levi know if you are on your cycle and at what point (beginning, middle, end) and/or if you are experiencing any other problems. You will want to bring pads from home (for travel). You cannot use a tampon during or after your surgery (the next cycle is fine). We can provide you with pads while you are in the hospital; but you will want to have some of your own for your journey home.

Are the doctors able to deal with complications? What about emergencies that could arise?

Dr. Perez. has seen about every conceivable complication or emergency that can arise in his many years as a surgeon and ob-gyn, and he has had success with some very difficult tube reconstructions. He and the hospital are equipped to handle any emergencies that may arise - the hospital is a Red Cross hospital and Dr. Perez has been in practice for 30 years.  

Will I be in pain? How do I get help when I am in pain?

Your pain will depend a lot upon your tolerance for pain, but most patients are not in extreme pain.  Some patients compare the pain as  being similar to that of a c-section, though not as intense.  If you are having trouble sleeping, or are in any pain, please tell the nurses. The nurses are very intuitive to your needs, and language barriers have not been a problem for the majority of patients. They will also check on you frequently.  A Spanish/English dictionary, or note cards, with a few words in Spanish - pain, hungry, can't sleep, sick, need doctor, and so on  could be helpful to take along. 

There is a very good (free) tutorial in the links section that would be very helpful for making note cards. 

Helpful Links   

Will I get pain meds to take home?  What about antibiotics? 

Dr. Perez will supply you with the necessary antibiotics and pain medications that you will need to take home after the surgery. There is no cost for this. Your travel methods and distance afterwards will also be a factor, but if you take your meds at the times prescribed, your pain should be minimal. You can bring additional over the counter medications (Tylenol Pm is highly recommended by patients)  for your travel, but you must check with the doctor before taking any additional medications to make sure there will be no adverse reaction with the medications you are being given in the hospital or taking home with you. 



If you have any questions, please email!!   Thank you!


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